Planet

Childhood obesity. The British example for Italy

November 1, 2018

Childhood obesity and overweight. The British government offers a model for risk analysis and management that should be followed soon by Health Minister Giulia Grillo. Here’s why.

Childhood obesity, risk analysis. England and Italy compared

The National Child Measurement Program(NCMP) collects anthropometric data on children in the first and last year of English elementary schools (ages 4-5 and 10-11). With the goal of assessing the overall status of their health-with support from PHE, Public Health England. (1) And offer useful tools for the development of coherent health policies, locally and centrally.

The collected data show that the indices of childhood obesity and overweight, in England, have remained stable in the first age segment (22.4 percent of the considered population). They increase, however, in the 10-11 age group, from 31.6 percent in 2006-2007 to 34.3 percent in 2016-2017.

The prevalence of severe obesity in the English child population is the most alarming finding. In fact, there was a 4.2 percent spike among children between the ages of 10 and 11. (2) With an increase of more than a third over the past decade. On another note, in both age groups (4-5 and 10-11 years) the rate of severe obesity is 4 times higher in disadvantaged areas. (3)

Conversely, in Italy, a national program for the permanent collection of data on overweight and obesity in children is not yet available. (4) According to the report by ‘Helpcode Italia’ Onlus–presented at Gaslini Hospital in Genoa on 9.10.18–obese children and young people number nearly one million, 9.3 percent of the total. Added to which there are 21.3 percent of those who are overweight. (5)

Childhood malnutrition, England and Italy. The paradox municipality

The paradox emerging from the analysis of English data is that already observed internationally. In developing countries as well as in an ‘advanced’ country such as England, obesity affects the most deprived sections of the population.

Social inequality-often accompanied by cultural inequality-is thus associated with malnutrition by excess, as well as by default. To blame unbalanced diets dominated by junk food (HFSS, High in Fat, Salt or Sugar) and deficient in vegetables and fruits. As well as, more generally, healthy foods.

The situation in Italy appears no different in this respect. La

Mediterranean diet

after all, as some studies reveal

, is a privilege reserved for the wealthier classes. And the ancient myth ‘

‘poor but beautiful

‘ collides with the needle on the scale.

Childhood malnutrition paves the way for obesity. Even in Italy, where 1 in 3 children is obese or overweight, due to poor eating habits and sedentary lifestyles. Ferrero’s slogan ‘Good Morning Enthusiasm‘ – as it is associated with the promotion of HFSS products – thus appears to be incongruous with the national epidemiological data. (6)

Childhood obesity, how to address a public health emergency. The example English

The risk of contracting obesity in adolescence is increased 20-fold in individuals who developed overweight or obesity in the first 5 years of life. (7) Such conditions expose minors to psychological problems (lower self-esteem, risk of being bullied, depression) destined to mark their existence personally and socially. (8)

2.8 million deaths each year in the EU are caused by obesity and overweight, which significantly increase the risk of cardiovascular disease (hypertension, coronary heart disease, heart attacks and strokes), metabolic dysfunction (type 2 diabetes, hypercholesterolemia) and cancer.

The

Childhood Obesity Plan

has been developed in recent years, by Her Majesty’s Government, for the specific purpose of addressing this public health emergency with appropriate instruments. The plan kicked off with the provision of a sugar tax

to producers of

soft drinks

.

The reformulation of foods Is itself essential. And that is why the British government has called on the food industry, in no uncertain terms, to reduce by 20 percent the energy value and calories of foods regularly consumed by children. (9)

Public Health England
recently met with representatives of the food supply chain (FBOs, distributors, mass caterers, and retail establishments). To discuss the implementation of the second chapter of the government plan against childhood obesity, where additional measures are established:

– mandatory calories on all foods served and sold outside the home (so-called out of home sector, including fast food and take-away),

–

HFSS foods

, drastic limits on advertising promotion,

– Energy-drinks, ban on sale to minors. (10)

Health Minister

Giulia Grillo

should seriously consider the English example, precisely as it is aimed at addressing the public health emergency affecting children. Without neglecting the nutrition policies recently developed in France. A #change from the policies of previous governments, which were merely subservient to

Big Food

but rather wholly inadequate.

Dario Dongo and Giulia Baldelli

Notes

(1) Public Health England is a public agency serving the British Department of Health and Social Care. An entity corresponding to the Istituto Superiore di Sanità (ISS), serving the Ministry of Health, in Italy

(2) Obesity is classified as severe if the

BMI

(

Body Mass Index

, Body Mass Index) is 35 or higher. See the article https://www.greatitalianfoodtrade.it/salute/indice-di-massa-corporea-e-patologie-cardiovascolari-una-ricerca-ne-evidenzia-le-implicazioni-anche-in-soggetti-sani

(3) The criteria for estimating obesity levels follow the guidelines of PHE, at

http://webarchive.nationalarchives.gov.uk/20170110173352/http:/www.noo.org.uk/uploads/doc/vid_11762_classifyingBMIinchildren.pdf

(4) The willingness to work on a permanent survey program, in conjunction with the Ministry of Health and the ISS, was expressed by the FIMP (Italian Federation of Pediatric Physicians). Through its president, Dr. Paolo Biasci, in view of World Obesity Day(Obesity Day, 11.10.18)

(5) The impact of childhood obesity on the National Health System is estimated at about 4.5 billion euros per year. Cf. https://www.gaslini.org/comunicati-stampa/obesity-day-2018-in-italia-1-milione-300-mila-minori-a-rischio-malnutrizione-nelle-famiglie-in-poverta/

(6) Although the mainstream media indulge on the fake news who falsely associate international obesity prevention policies with hypothetical plots against the Made in Italy Feeding. See in this regard the articles

https://www.greatitalianfoodtrade.it/idee/fake-news-nel-settore-alimentare-il-quibus

e

https://www.greatitalianfoodtrade.it/salute/schizzi-di-nutella-sull-oms

(7) See Mandy Geserick, M.Sc., Mandy Vogel, Ph.D., Ruth Gausche, M.B.A., Tobias Lipek, M.D., Ulrike Spielau, M.Sc., Eberhard Keller, M.D., Roland Pfäffle, M.D., Wieland Kiess, M.D., and Antje Körner, M.D. et al., ‘‘Acceleration of BMI in Early Childhood and Risk of Sustained Obesity’, in New England Journal of Medicine 2018; 379:1303-1312, doi 10.1056/NEJMoa1803527

(8)

Robert J Noonan and Stuart J Fairclough,’Cross-sectional associations between body mass index and social-emotional wellbeing among differentially active children’, in

European Journal of Public Health

, cky208,